Azygos-Atrial Bypass in Catheter Associated Superior Vena Cava Syndrome

Abstract

Thrombogenic superior vena cava syndrome is an uncommon, dangerous complication of long-standing central venous catheter use. The increased use of central venous catheters has resulted in more non-malignant cases of superior vena cava syndrome across all age groups.A 23-year-old patient who underwent Hemodialysis (HD) due to Chronic Renal Failure, was admitted to our clinic with swelling in the neck, face, and eyes 2 years after the insertion of a double-lumen indwelling catheter for HD.Beside those complaints, the patient had active bleeding from trachea. After venography, it was observed that there was complete occlusion in the Superior Vena Cava(SVC) and the upper venous system was drained into the Right Atrium via the Azygos vein and the Azygos vein was fully occluded where it was poured into the Atrium. Surgical decision was given together with Interventional Radiology.The operation was performed with sternotomy.After sternotomy, an Azygos-Atrial bypass was performed as an Off-Pump technique. On the first postoperative day, the edema in the neck, face and eyelids decreased. The patient, who had no complaints in the follow-ups, was discharged with medical treatment.